Laser Eye Surgery results FAQ
If you’re looking for our results, you can review the London Vision Clinic’s statistical results and patient reviews.
Can I go blind after Laser Eye Surgery?
Essentially, no. Technically there is an exceedingly small risk of blindness with laser eye surgery but it is lower than the risk of wearing monthly contact lenses for one year, so a risk that everyone seems to accept as perfectly reasonable.
How long will it take to get back to normal activity — like exercise, showering, working, or flying?
The following is our recommended activity schedule for patients who have had LASIK:
- Be very careful to avoid any activity that could lead to something touching or poking your eyes.
- Rest and keep your eyes closed for the first few hours after surgery. Once things have settled, you can resume normal activity at home.
- Avoid rubbing your eyes. Instead, use lubricant drops for any itching or dryness.
24 Hours after surgery
- Take a bath instead of a shower. Avoid getting any soap or tap water in your eyes.
- You can read and watch TV as long as you do not let your eyes dry out.
- LASIK patients tend to return to work, but you should keep your eyes well lubricated with artificial tears (staring at computer screens can dry your eyes). This does not affect the outcome but can cause temporary visual fluctuations.
- Flying is acceptable but again, but you will need to lubricate your eyes- as the air is very dry in airplanes.
48 Hours after surgery
- At this stage, your cornea will heal. This means that normal activities such as showering and wearing makeup are acceptable.
Day 3 activities
- You can take exercise that does not affect your eyes such as using a treadmill, or stationary bike, but not swimming.
- You can play with small children but be careful they do not poke you in your eye!
Week 2 activities
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- Racquet sports, tennis, squash, racquetball, badminton (but always wear eye protection)
- Swimming (with goggles)
- Scuba diving, snorkelling
- Motorcycling, dirt biking, mountain biking
- Skiing (with goggles)
- Avoid high-impact sports such as martial arts, boxing, and water-skiing until at least one month after LASIK.
When can I drive after surgery?
We advise you not to drive until after the 1st-day aftercare appointment. Driving short distances after the 1st-day appointment is acceptable if we confirm adequate vision at the evaluation.
When can I wear makeup after Laser Eye Surgery
You can apply makeup 48 hours after Laser Eye Surgery. However, we advise you not to apply eye makeup until 7 days after your surgery. Furthermore, you must be careful not to rub your eyes when removing your eye makeup.
When can I get back to work?
LASIK patients can plan to return to work 24 hours after surgery, but need to keep their eyes well lubricated with artificial tears (staring at computer screens can dry your eyes). This does not affect the outcome but can cause temporary visual fluctuations. LASEK patients should plan to return to work after 7 days.
What are my chances of seeing 20/20 after Laser Eye Surgery?
Your chance of seeing 20/20 after Laser Eye Surgery at London Vision Clinic depends on your pre-operative prescription. If you would like to review our results for patients with your prescription, check out our results and stats page.
What are the long-term results of Laser Eye Surgery?
In regards to distance correction, it’s necessary to mention that there are no published very long-term outcomes of Laser Eye Surgery. However, corneal flaps have been created in the cornea for approximately over 50 years (in procedures such as keratomileusis as described and performed by Barraquer since the 1950’s), the excimer laser has been used for almost 20 years in the cornea and there have been approximately 17 million procedures performed to date worldwide.
However, corneal flaps have been created in the cornea for approximately over 50 years (in procedures such as keratomileusis as described and performed by Barraquer since the 1950’s), and Excimer laser (which we use today) has been used for almost 20 years, racking up approximately 17 million procedures worldwide.
Professor Reinstein was one of the key contributors to the National Institute of Health and Clinical Excellence (NICE) Guidance Document on LASIK, which determined the procedure was safe and effective and that there were no serious concerns about the long-term safety of the procedure if performed with the latest technology and techniques.
What is the worst thing that can happen following surgery?
With over 50 million procedures performed world-wide to date and a 25 year track record of improvements, Laser Eye Surgery is one of the safest options for vision correction. Just as contact lenses are not risk free, neither is laser eye surgery. However, in expert hands, the safety of laser eye surgery is similar to that of daily contact lens wear, and even safer than extended wear contact lenses.
It is not possible to fully summarise this information here, and all our patients undergo an extremely detailed process to gain informed consent for surgery. Patients at the London Vision Clinic will spend at least two hours, and often longer, for full assessment and discussion about risks with our surgeons and optometrists before proceeding to vision correction surgery. If a patient wants more time, this is easily arranged. This investment of time on our part for each patient, we are confident, is second to none.
The fact is that an expert laser eye surgeon will have the knowledge to manage complications properly and will most probably be able to correct complications that may occur. One may think of this in terms of the difference between a GP or a midwife delivering a baby versus a specialist obstetrician.
When we define what constitutes a complication, one way is to think in terms of damage to the vision. Damage to the vision would mean some blurring, doubling, distortion or something not right with the vision that could no longer be corrected by spectacles to the level before surgery. Overall, 98% of people with a refractive error have blurring, doubling or distortion without glasses, but can see down to the 20/20 line with glasses. Scientifically we define a ‘small amount of damage’ to mean that the eye has lost two lines on the vision chart, even with spectacles, compared to the vision before surgery. For an eye that could see 20/20 with glasses before surgery, the vision with glasses after surgery would be 20/30, which is still within the legal driving standard.
In the hands of an expertly trained surgeon, operating with the optimal technology for diagnostics and treatment, the chance of a small amount of damage to the vision is approximately 1 in 1,000 for most cases.
The chances are extremely low that an expert laser eye surgeon would face a complication that he or she would not be able to either fully correct or almost fully correct. This is because an expert surgeon can manage most complications, as long as they have advanced diagnostic equipment such as the Artemis Insight 100 Insight VHF digital ultrasound scanner and high resolution OCT (optical coherence tomography), and the repair tool technology: phototherapeutic keratectomy (PTK) technology and topography-guided laser technology. At the London Vision Clinic, not only do we have every single diagnostic and therapeutic option available to us in the unlikely event that we would need it, Professor Reinstein and his team have been responsible for developing many of these tools for the benefit of experts around the world.
We keep meticulous records of all our statistics and have follow-up rates that are literally second to none. Over the last 15 years, the London Vision Clinic has published more scientific papers in the field of refractive surgery than any other provider, and we are leading developers of complication repair techniques and technology. We manage to see 90% of all patients we treat at 1 year and many continuously thereafter for routine follow-up. Most providers discharge patients once they are seeing well after 1 month or 3 months, and are therefore unable to provide final statistics for 1 year outcomes. Our own audited track record for patients in whom we were unable to recover vision to within 2 lines of the original best spectacle corrected vision shows that the chance of this happening is 0.02% (5 eyes out of 25,500 procedures) where we treated short-sightedness (myopia) up to ‑14.00 D, long-sightedness (hyperopia) up to +7.00 D, and astigmatism up to 6.00 D, as well as eyes with the more unusual form of mixed astigmatism.
For more information on the risks of laser eye surgery and their management, do contact us. We are happy to talk about this openly and transparently.
What’s the likelihood of needing an enhancement?
We’ll only perform enhancements if the patient has a real potential of seeing better than they do after their initial treatment, and, of course, if it is completely safe to do so.
Our current enhancement rate is 5% for short-sighted patients and 8% for long-sighted patients. At London Vision Clinic, we pride ourselves in helping our patients achieve the best possible visual results. Therefore, even if a patient is 20/20 after an initial Laser Eye Surgery procedure, but has the potential to see better, we’ll offer a complimentary enhancement to help them achieve a better quality of vision.
4 out of 5 (80%) of our short-sighted patients up to -9D can see 20/16 or better after all treatments, while almost half (47%) of our longsighted patients up to +6D can see 20/16 or better after all treatments.
What keeps the corneal flap in position after LASIK surgery?
Initially, a vacuum effect keeps the corneal flap in position. The cells lining the inner surface of your cornea, known as endothelial cells, pump water out to the inner part of the eye. This suction holds the corneal flap in place.
During the first day or two after Laser Eye Surgery, the outer surface of the cornea, known as the epithelium, seals the edges of the corneal flap. Over the next few weeks, natural substances inside the cornea bond the corneal flap to the underlying tissue.
Could my corneal flap become loose?
The corneal flap attaches to the rest of the cornea by a solid hinge. However, if you rub your eye shortly after surgery, there is the possibility that the corneal flap will dislodge. Your surgeon would then have to reposition the corneal flap in the operating room.
Very rarely, the microkeratome instrument will cut a free cap, without a hinge. This affects about one in 1,500 cases. If this happens, the surgeon will replace the cap after the laser part of the procedure. We will tell you this has happened and warned to take extra care not to rub your eye soon after surgery, to reduce the risk of losing the free cap. Even in the days when surgeons did Laser Eye Surgery without a hinge, it was extremely rare for anyone to lose the part of the cornea that a surgeon had cut and replaced.
If your cap was lost, your cornea would become thinner, and there would be a chance of scarring. Overall, your vision would still likely be quite good, although surgeons consider this a serious complication. There’s an extremely remote possibility you would need a corneal transplant.
What causes night time side effects after Laser Eye Surgery and can they be treated?
Few people develop side effects from Laser Eye Surgery. Of those who do, problems such as glare and halos, affecting night vision, are among the most common. There are several reasons for this.
If the laser did not change the shape of your eye enough during your first procedure, you may still be slightly short or long-sighted, and/or still have a minor astigmatism. A follow-up procedure or wearing glasses at night can help this.
The size of your pupils can be another cause of glare and halos. If a patient’s pupils dilate (open) beyond the area of the cornea that the laser has treated during Laser Eye Surgery, glare and halos may consequently appear in low light conditions. A surgeon can prevent this by measuring your dilated pupil size very accurately before surgery. The surgeon can determine whether they can effectively treat a large enough area of your cornea with the laser. If this were not possible, then they would disqualify you from surgery.
If you do have glare or halos at night following Laser Eye Surgery because of your pupil size, a few techniques can help. Some patients find that, when driving, keeping the overhead light on inside their car stops their pupils dilating so much that it affects their vision. Some people find medicated eye drops that stop their pupil from dilating fully helpful.
Finally, Laser Eye Surgery can cause glare and halos if the area of your cornea treated by the laser is off to one side (off-centred ablation). Choosing a properly qualified and experienced Laser Eye Surgeon can help to minimise the risk of these complications. This is especially important, since to date, there is no entirely satisfactory solution available. Using Wavefront technology may significantly reduce the risk of glare, halos, and night vision difficulties.
What causes dry eyes after laser vision correction?
The corneal nerves send information to the lacrimal gland to bring a continual supply of lubrication to the eye. However, techniques such as LASIK and PRK disrupt the corneal nerves so that they can no longer supply the appropriate information and therefore lubrication to the eye.
A small number of patients with pre-existing dry eyes are at risk of prolonged dry eyes, and some patients even years after Laser Eye Surgery have dryer eyes than before the surgery.
In general, the use of artificial tears is very important following LASIK and PRK. Careful discussion with our nurse both before and after your surgery is important in determining the amount of lubrication required. In severe dry eye cases, patients can use a punctal plug.
In severe dry eye cases, patients can use a punctal plug. A punctal plug is a plastic plug that prevents the outflow of tears from your eye to the nose. This device can raise the amount of lubrication in the eye, just like plugging the drain of a sink. A surgeon can place and remove the plastic plugs can be months later, if required.
Can my vision return to its original level after surgery?
Some patients experience a regression of results following surgery, but not to their preoperative level. An expert Laser Eye Surgeon can fine-tune or enhance the surgery to further improve the vision if necessary.
How can I interpret statistical results of Laser Eye Surgery?
When you look closely at a surgeon’s overall results and their specific results for each type of prescription range, the difference between patient groups is clear.
Generally, the lower your prescription before surgery the higher the likelihood of a better outcome after surgery. When looking at results tables, you must be sure to compare like with like. If your prescription is minus five (-5.00d) and the results tables are showing data from a patient group with prescriptions up to minus three (-3.00d), then this data does not tell you about your chance of a successful outcome.
In fact, results including patients with lower starting prescriptions (-3.00 and below for example) will skew the overall results so this can be misleading for a patient with a higher (-5.00) starting prescription.
This also applies in the opposite direction. If you have a low prescription but the results tables show a wide range of patients, including those with very high prescriptions, the overall data would suggest poorer results than you are likely to experience. The closer the data is to your own situation, the more accurate they will be about your individual chance of achieving a successful result.